USE OF THERMAL AND 3D IMAGING TO QUANTIFY ARTHRITIS

使用热成像和 3D 成像来量化关节炎

• 批准号: 7567325
• 负责人: Raphael Hirsch
• 金额: $ 17.87万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-15 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7567325
• 关键词: 3-Dimensional; Adrenal Cortex Hormones; Anti-Tumor Necrosis Factor Therapy; Arthralgia; Arthritis; Childhood; Chronic Childhood Arthritis; Clinic Visits; Clinical; Clinical Research; Clinical assessments; Devices; Disease; Disease remission; Dose; Drug Delivery Systems; Evaluation; Goals; Hand functions; Health; Heating; Image; Inflammation; Inflammation Mediators; Inflammatory; Injection of therapeutic agent; Interobserver Variability; Intervention; Joints; Lasers; Magnetic Resonance Imaging; Measurement; Measures; Metacarpophalangeal joint structure; Methodology; Oral; Outcome Assessment; Patient Care; Patient Monitoring; Patients; Pattern; Peripheral; Pharmaceutical Preparations; Physicians; Questionnaires; Recording of previous events; Reporting; Reproducibility; Research Design; Rheumatoid Arthritis; Rheumatology; Self Assessment; Surface; Swelling; Synovitis; Testing; Therapeutic Intervention; Time; Variant; Wrist; clinical remission; cohort; cost; functional status; improved; prototype; public health relevance; response; sensor; tool

DESCRIPTION (provided by applicant): One of the biggest challenges in caring for patients with Rheumatoid Arthritis (RA) and Juvenile Rheumatoid Arthritis (JRA) is quantifying the degree of disease activity in any given joint. It can even be difficult to determine whether inflammation is present or absent. Carefully designed studies have repeatedly shown poor We have built a prototype device using well-established sensors-specifically 3-dimensional (3D) laser line triangulation digitizer cameras and thermal infrared cameras-to rapidly quantify surface swelling and heat in arthritic joints. This Arthritis Surface Imager produces results within minutes. Thus it could become a routine component of the rheumatology clinic visit, allowing for the replacement of the current subjective and unreliable joint assessment with a quantitative and highly-reproducible measure that can be used to monitor patients over time. The goal of our studies is to test the hypothesis that this Imager can improve the clinical assessment of arthritis. The first Specific Aim is to test the hypothesis that surface imaging will provide an earlier and more sensitive measure of change in active arthritis and functional status than do physician's assessment and patient's self-assessment A cohort of patients with JRA and RA will be followed longitudinally before and during the course of a therapeutic intervention. Change in arthritis, as measured by the Arthritis Surface Imager will be compared to well-established and validated clinical measures, including 1) physician's assessment of joint tenderness and swelling and 2) patient's self-assessment of joint pain. Correlation will also be made with changes in functional status, as assessed by components of the Childhood Health Assessment Questionnaire (CHAQ) and Health Assessment Questionnaire (HAQ) that pertain to hand function. We will also examine predictors of change in functional status. The second Specific Aim will test the hypothesis that surface imaging can improve the accuracy of remission measurement. It has recently been reported that patients in clinical remission often have MRI evidence of continued synovitis, demonstrating that current clinical measures of inactivity do not correlate well with true remission. Our Preliminary Studies suggest that many patients with a history of arthritis have abnormal joint thermal patterns even when asymptomatic. Patients with clinically-inactive disease will be imaged by MRI to determine whether patients with subclinical arthritis can be identified by the Arthritis Surface Imager. Low-cost, time-efficient tools that produce a set of reliable, reproducible and objective measures of the inflammatory state of the joint would improve the assessment of outcome in arthritis clinical studies, and ultimately will improve patient care. This proposal focuses on the wrist and metacarpophalangeal (MCP) joints, which make up 22 of the 28 joints in the Disease Activity Score (DAS) 28. Methodologies developed here could be readily applied to other peripheral joints. reproducibility of physician assessment of the number of swollen and/or tender joints. PUBLIC HEALTH RELEVANCE: One of the biggest challenges in caring for patients with Rheumatoid Arthritis (RA) and Juvenile Rheumatoid Arthritis (JRA) is quantifying the degree of disease activity in any given joint. We have built a prototype device using well-established sensors to rapidly quantify surface swelling and heat in arthritic joints. The goal of our studies is to test the hypothesis that this Imager can improve the clinical assessment of arthritis.

描述（由申请人提供）：照顾类风湿关节炎（RA）和少年类风湿关节炎（JRA）的最大挑战之一是在任何给定关节中量化疾病活性程度。甚至很难确定是否存在炎症或不存在炎症。精心设计的研究反复表明，我们已经使用良好的传感器特定于3维（3D）激光线三角数字化数字摄像机和热红外摄像头构建了原型设备，从而在关节炎关节中快速量化表面肿胀和热量。这种关节炎表面成像仪会在几分钟内产生结果。因此，它可以成为风湿病诊所访问的常规组成部分，从而允许使用定量且高度可复制的措施来替换当前的主观和不可靠的关节评估，可用于随着时间的流逝来监测患者。我们研究的目的是检验该成像器可以改善关节炎临床评估的假设。第一个具体目的是检验以下假设：与医师的评估和患者的自我评估相比，表面成像将提供对活动性关节炎和功能状态变化的更早，更敏感的量度。通过关节炎表面成像仪测量的关节炎的变化将与已建立和验证的临床措施进行比较，包括1）医师对关节压痛和肿胀的评估以及2）患者对关节疼痛的自我评估。相关性也将与功能状态的变化建立，这是由儿童健康评估问卷（CHAQ）和健康评估问卷（HAQ）的组成部分评估的，与手部功能有关。我们还将检查功能状态变化的预测指标。第二个特定目的将检验以下假设：表面成像可以提高缓解测量的准确性。最近有报道说，临床缓解的患者通常具有持续滑膜炎的MRI证据，这表明当前的不活动临床测量与真实缓解无关。我们的初步研究表明，许多关节炎史的患者即使无症状也具有异常的关节热模式。 MRI将成像临床上无效疾病的患者，以确定是否可以通过关节炎表面成像鉴定亚临床关节炎患者。低成本，耗时的工具，可产生一组可靠的，可重复的和客观的关节炎症状态，可以改善关节炎临床研究中预后的评估，并最终将改善患者护理。该提案的重点是腕部和掌pophangeal（MCP）关节，该关节构成了疾病活动评分（DAS）28个关节中的22个。医师评估肿胀和/或招标关节数量的可重复性。 公共卫生相关性：照顾类风湿关节炎（RA）和少年类风湿关节炎（JRA）的最大挑战之一是量化任何给定关节的疾病活动程度。我们已经使用完善的传感器构建了一个原型设备，以快速量化关节炎关节中的表面肿胀和热量。我们研究的目的是检验该成像器可以改善关节炎的临床评估的假设。